Knowledge and Perceptions of Hepatitis B and Hepatocellular Carcinoma Screening Guidelines Among Trainees: A Tale of Three Centers.
Dig Dis Sci
; 65(9): 2551-2561, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-31813133
ABSTRACT
BACKGROUND:
Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC) worldwide, disproportionately affects minorities in the USA. Undiagnosed HBV precludes HCC screening and contributes to late-stage cancer presentation and decreased survival. Barriers to HBV and HCC screening include lack of insurance and limited diffusion of guidelines. We aimed to assess knowledge about HBV and HCC screening indications and explore barriers to screening.METHODS:
We surveyed trainees from the University of Miami/Jackson Memorial Hospitals, Palmetto General Hospital, and Mount Sinai Medical Center. We assessed knowledge using clinical vignettes. We performed bivariate and Chi-squared analyses.RESULTS:
There were 183 respondents; median age was 31 and 52% were male. The sample was 35% Hispanic, 29% White, 18% Asian, and 9% Black. Training department was Internal Medicine, 71%; Family Medicine, 11%; Infectious Diseases, 6%; or Gastroenterology, 7%. Only 59% correctly estimated national HBV prevalence; 25% correctly estimated global prevalence. In vignettes with behavioral risk factors, trainees correctly advised screening, 63-96%. However, when the risk factor was the birthplace, correct responses ranged from 33 to 53%. Overall, 45% chose an incorrect combination of HBV screening tests. Perceived barriers to screening included limited expertise in screening of immigrants and limited patient education. Respondents were more likely to recommend HCC screening in cirrhotic patients versus non-cirrhotic HBV patients. Key barriers to HCC screening included uncertainty about HCC guidelines and patient financial barriers.CONCLUSIONS:
Knowledge of HBV and HCC screening recommendations is suboptimal among trainees. Efforts to broadly disseminate HBV and HCC guidelines through targeted educational interventions are needed.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Atitude do Pessoal de Saúde
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Conhecimentos, Atitudes e Prática em Saúde
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Guias de Prática Clínica como Assunto
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Carcinoma Hepatocelular
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Hepatite B Crônica
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Detecção Precoce de Câncer
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Internato e Residência
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Neoplasias Hepáticas
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Guideline
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Prevalence_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
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Screening_studies
Limite:
Adult
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Female
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Humans
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Dig Dis Sci
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos